Ultrasound examination of the musculoskeletal system is a rapidly developing and widely used diagnostic method. This technology is constantly expanding the possibilities of its application: ultrasound diagnostics of the musculoskeletal system in some clinical situations significantly complements the morphological picture of the disease, and in some cases can already replace magnetic resonance imaging.
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The diagnostician records the detected violations in the area under study in detail in the protocol. With this document, the patient must go to an appointment with an orthopedist, where a further decision on treatment tactics will be made. In his conclusion, the ultrasound doctor does not make a diagnosis, but only describes in detail all the anomalies. The final diagnosis is made only by the attending physician, based on the anamnesis, the results of all studies, and only he makes a decision on further treatment.
Previous NextHow is an ultrasound of the hand performed at the Medicenter?
The patient is in a sitting position, with his hands folded on his knees. The doctor scans the area of the hand and may ask the patient to turn the palm in one direction or another to examine the hand in different planes.
The ultrasound procedure of the hand is painless, does not require preliminary preparation and takes no more than 20 minutes, and the patient receives the results almost immediately after the scan. If an ultrasound reveals a particular pathology, the patient is referred to the appropriate doctor.
When may an ultrasound examination of the hand and wrist joints be required?
Ultrasound of the wrist and hand joints is indicated for pain, swelling, and limited mobility of the hand. Ultrasound allows you to visualize the presence of fluid in the joint cavity, defects in the articular surfaces, and the blood supply to the synovium and surrounding tissues.
Main indications for ultrasound of the wrist joint:
- arthritis;
- deforming osteoarthritis;
- accumulation of fluid in the joint cavity;
- hemorrhage into the joint cavity;
- olecranon fracture;
- damage (sprain/rupture) of ligaments and tendons;
- damage to the nerve trunk, tunnel syndrome;
- bursitis.
Indications for ultrasound of hand joints:
- soreness in the hand;
- change in appearance, deformation of fingers;
- change in skin color;
- swelling of the entire hand or part of the hand;
- the appearance of neoplasms;
- inability to move your arm and perform usual actions;
- sprain, rupture of ligaments;
- inflammation of tendons, soft tissues.
Ultrasound is also used in examining patients with endocrine and autoimmune pathologies, and with congenital pathologies of the musculoskeletal system. Ultrasound of the joints of the hand and wrist allows you to assess the structure and integrity of muscles, ligaments and tendons, and identify signs of congenital and acquired diseases, such as rheumatoid arthritis, Marfan syndrome, gout.
Preparation for ultrasound of arteries and veins of the hands
Doppler ultrasound is a non-invasive research method that does not require complex preparation. The day before the procedure, heavy physical activity should be avoided. It's important to get a good night's sleep.
In order for the diagnosis to be reliable, it is necessary to stop using substances that can affect the condition of blood vessels:
- tobacco;
- alcohol;
- coffee;
- tea;
- energy drinks.
It is recommended to have a light snack before visiting the clinic. Creams and other cosmetics should not be applied to the skin of the hands.
Before a vascular ultrasound, you should give up coffee
Difference between ultrasound and duplex and triplex examination of vessels of the upper extremities
Ultrasound Dopplerography (Doppler ultrasound) of the vessels of the upper extremities —
an outdated method that is sometimes still used. During Doppler sonography, only the patency of the vessel and the speed of blood flow can be determined. If a blockage is detected, it is impossible to clarify the cause, since with this method the doctor does not see the vessel. During an ultrasound examination, the doctor can only guess about the cause of the disease based on the speed of blood flow, pulse sinusoid frequency, and blood pressure.
Duplex scanning of vessels (USDS) allows you to visualize the vessel in black and white. It is possible to evaluate not only the patency of the vessel and the speed of blood flow, but also to find the reasons that led to the violation: narrowing, tortuosity, abnormal development of the vessel; blood clots; atherosclerotic plaques, etc. During a duplex ultrasound, the doctor uses two ultrasound modes: ultrasound visualization of the wall and lumen of the vessel in gray tones and spectral Doppler ultrasound (USDG).
During a triplex study of hand vessels, in addition to the above modes, a third mode is additionally used - color Doppler blood flow mapping (CDB). Triplex vascular study is sometimes called a more complex name - duplex vascular study using color coding of blood flow (CDC).
Triplex ultrasound of the vessels of the upper extremities expands the capabilities of duplex scanning by displaying the direction of blood flow in red and blue. The color indicates to the doctor the direction of blood flow: shades of red - towards the ultrasound sensor, shades of blue - away from the sensor. Higher blood flow speeds are colored in lighter tones of red or blue, and low ones are colored in darker tones.
With triplex ultrasound, a more accurate diagnosis is achieved, since using three different scanning modes it is easier for the doctor to see areas of vessel narrowing, turbulence in blood flow, areas of lack of blood flow, and identify atherosclerotic plaques, blood clots, abnormalities in vascular development and their significance. In addition, the color mode allows you to detect small vessels that cannot be detected with black and white imaging
What does an ultrasound examination of the arteries and veins of the arms show?
During the ultrasound examination process:
- determine the diameter of the lumen and the condition of the walls of blood vessels;
- detect congenital anomalies and pathological inclusions (cholesterol deposits, blood clots, etc.);
- study the parameters of blood flow: pressure, speed, presence of turbulence.
During the procedure you can find:
- atherosclerotic plaques - in the lumen of the arteries, light hyperechoic formations are visualized, tightly fixed to the wall;
- inflammation (vasculitis) - characterized by swelling, narrowing of the diameter of arteries and veins;
- congenital angiodysplasia (vascular malformations) - malformations can be seen on the images. aneurysms and other abnormalities that interfere with normal blood flow;
- thrombosis - the main ultrasound sign of this pathology is the presence in the lumen of a vein or artery of a hypoechoic dark clot, which becomes especially dangerous during flotation phenomena;
- embolism - blockage of a vessel by a material object: a blood clot, a fragment of adipose tissue or bone marrow, air bubbles, etc.;
- stenosis of arteries and veins - characterized by temporary (against the background of spasm) or permanent (with scar deformities, injuries, compression by a tumor, etc.) local narrowing of the lumen of the bloodstream.
Ultrasound of hand vessels. The arrow indicates an atherosclerotic plaque
Advantages of performing ultrasound of small joints at the Doctor Ryad clinic
All those who want a diagnostic ultrasound examination to be as effective and accurate as possible turn to the clinics of our network. We have modern equipment that allows our diagnosticians to work real miracles. They are able to recognize even minor disorders in the initial stages of their development, which, in turn, allows timely initiation of treatment and achievement of its desired results.
We do not have queues, since appointments are by appointment only. This is very convenient, because you can make an appointment right now at any time convenient for you by calling the number: +7 (495) 153-01-33. You can find out our prices in the price list below.
Initial conservative treatment
Initial therapy usually involves the use of the following methods:
- load limitation;
- orthotics;
- taking non-steroidal anti-inflammatory drugs;
- physiotherapy.
This treatment is highly effective in the early stages of tendinitis. But it does not always work in advanced stages of pathology. The mistake patients make is that they endure pain for a long time before turning to a specialist. As a result, they continue to load the hand, the disease progresses, and it becomes more difficult to treat.
Goals of initial therapy:
- elimination of inflammation;
- pain reduction;
- strengthening the muscles and ligaments of the hand;
- providing functional rest for the restoration of damaged tissues.
Compliance with the ergonomic regime is a key point in the treatment of the disease. Since the main cause is monotonous, repetitive movements, when these movements are eliminated, the symptoms of wrist tendonitis gradually regress. The patient is advised to avoid movements with the hand deviating towards the ulna, eliminate repetitive pinch grips, and reduce the total time of load on the hand. It is worth improving the ergonomics of working at a computer and using a more comfortable hand position when using a smartphone. Breaks when putting pressure on the hand should be taken every 10 minutes. To perform the job, you can use orthoses that limit unwanted movements.
Drug therapy – eliminates symptoms. Some patients may have pain in the hand at rest or with minimal household activity. This is the result of inflammation and swelling of tissues, which can be relieved with medications. Initially, nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for 7-10 days. In the future they are accepted upon request.
Additional methods of drug treatment:
- gels with non-steroidal anti-inflammatory drugs;
- warming ointments;
- compresses with dimethyl sulfoxide.
Physical therapy – improves blood flow in the wrist, reduces swelling and inflammation. Like NSAIDs, this is a symptomatic treatment method. The main options for physiotherapy: cryotherapy, magnetic therapy, laser therapy, shock wave therapy. A total of at least 10 procedures are required.
Orthotics - limit only unwanted movements, but generally preserve the mobility of the hand. The wrist joint with radial styloiditis is fixed in a neutral position or in extension at an angle of 15 degrees. The first finger is fixed at an angle of 45 degrees, and the first metacarpophalangeal joint is fixed in a flexion position at an angle of 10 degrees. In this case, the first (thumb) finger is kept in the functional position. But if pain persists, the interphalangeal joint can be fixed in extension.
Taping is an orthotics option that involves the use of adhesive cotton tapes. The peculiarity of the technique is that a correctly applied elastic tape lifts the skin, improving blood circulation and normalizing the outflow of lymph. Therefore, taping has an additional anti-edematous effect. By improving proprioception and normalizing relationships within the joints, pain is reduced.